Antimicrobial Biomaterials for Cranioplasty: A Systematic Review

用于颅骨成形术的抗菌生物材料：系统评价

Cranioplasty is a surgical procedure performed to reconstruct the calvarium, yet it carries a significant risk of infection and subsequent graft failure. Surgical asepsis, systemic antibiotic prophylaxis, and topical antiseptics may reduce this risk, but recent attention has focused on incorporating antimicrobial agents or properties directly onto or into the implant. This systematic review assesses the efficacy of antibacterial-modified cranioplasty grafts in reducing infection risk. Antimicrobial modifications to cranioplasty materials show promising preclinical results, with favorable local release profiles and minimal systemic distribution. Early clinical experiences suggest a possible reduction in infection rates, but the current evidence is limited by small sample sizes and methodological biases. Well-designed comparative trials with standardized reporting are necessary to establish definitive clinical efficacy and to guide optimal material-antibiotic combinations and delivery methods.

颅骨成形术是一种用于重建颅骨的外科手术，但它存在感染及后续移植物失效的显著风险。外科无菌操作、全身性抗生素预防和局部消毒剂可能会降低这种风险，但近期的关注点集中在将抗菌剂或抗菌特性直接融入或附着于植入物上。本系统评价评估了抗菌改性颅骨成形术移植物在降低感染风险方面的有效性。对颅骨成形术材料进行的抗菌改性在临床前研究中显示出了有前景的结果，具有良好的局部释放特性和极少的全身分布。早期临床经验表明感染率可能有所降低，但目前的证据受限于样本量小和方法学偏倚。需要开展设计良好且报告规范的对照试验，以确定其确切的临床疗效，并指导优化材料 - 抗生素组合及给药方式。

REF: Chaudri T, Belli A, Davies DJ, Stevens AR. Antimicrobial Biomaterials for Cranioplasty: A Systematic Review. World Neurosurg. 2025;199:124075. doi:10.1016/j.wneu.2025.124075 PMID: 40373969

Preoperative Differentiation of Spinal Schwannoma and Meningioma Using Machine Learning-Based Models: A Systematic Review and Meta-Analysis

基于机器学习模型的脊柱神经鞘瘤与脊膜瘤术前鉴别：系统评价与荟萃分析

Regarding the differences in surgical approaches for spinal schwannomas and meningiomas, preoperative differentiation of spinal schwannomas and meningiomas can be important in managing these lesions. This study evaluated the diagnostic performance of machine learning (ML)-based models in the differentiation of spinal schwannomas and meningiomas. ML-based models have a high diagnostic accuracy in preoperative differentiation of spinal schwannomas and meningiomas.

关于脊髓神经鞘瘤和脊膜瘤手术方法的差异，术前鉴别脊髓神经鞘瘤和脊膜瘤对于处理这些病变可能很重要。本研究评估了基于机器学习（ML）的模型在鉴别脊髓神经鞘瘤和脊膜瘤方面的诊断效能。基于机器学习的模型在术前鉴别脊髓神经鞘瘤和脊膜瘤方面具有较高的诊断准确性。

REF: Hajikarimloo B, Mohammadzadeh I, Hashemi R, et al. Preoperative Differentiation of Spinal Schwannoma and Meningioma Using Machine Learning-Based Models: A Systematic Review and Meta-Analysis. World Neurosurg. 2025;199:124096. doi:10.1016/j.wneu.2025.124096 PMID: 40398809

The Impact of Total Hip Arthroplasty on Lumbar-Specific Outcomes and Complications in Patients with Lumbar Spinal Fusion: A Systematic Review

全髋关节置换术对腰椎融合患者腰椎相关结局及并发症的影响：系统评价

Hip-spine syndrome, characterized by coexisting hip arthritis and degenerative lumbar spine disease, is prevalent in the aging population. While prior research has examined how lumbar spinal fusion (LSF) affects total hip arthroplasty (THA) outcomes, the impact of THA on lumbar-specific outcomes after LSF remains underexplored. This systematic review consolidates evidence on how THA timing and presence influence lumbar-specific outcomes and complications in patients undergoing LSF. To our knowledge, no prior systematic review has been performed on this topic. Lumbar-specific complications are increased following concomitant THA and LSF and may be affected by the order the surgeries are performed. Strategic planning of surgical interventions is essential to optimize outcomes for patients with concomitant hip and lumbar spine pathology.

髋 - 脊柱综合征以髋关节炎和退变性腰椎疾病并存为特征，在老年人群中较为常见。此前的研究已探讨了腰椎融合术（LSF）如何影响全髋关节置换术（THA）的预后，但THA对LSF后腰椎相关预后的影响仍未得到充分研究。本系统评价整合了有关THA的时机和实施情况如何影响接受LSF患者的腰椎相关预后和并发症的证据。据我们所知，此前尚未有关于该主题的系统评价。同期进行THA和LSF会增加腰椎相关并发症，且可能受手术顺序的影响。对于同时患有髋部和腰椎疾病的患者，精心规划手术干预措施对于优化预后至关重要。

REF: Gong DC, Richey BP, Stern EA, et al. The Impact of Total Hip Arthroplasty on Lumbar-Specific Outcomes and Complications in Patients with Lumbar Spinal Fusion: A Systematic Review. World Neurosurg. 2025;199:124076. doi:10.1016/j.wneu.2025.124076 PMID: 40373970

Cerebral Air Embolism After Percutaneous Kyphoplasty: A Case Report and Systematic Review of Mechanisms and Management

经皮椎体后凸成形术后脑空气栓塞：病例报告及机制与处理的系统评价

Cerebral air embolism (CAE) is a rare but catastrophic complication of percutaneous kyphoplasty (PKP), with only 6 documented cases in spinal surgery literature. This study presents a novel case of CAE following PKP, resulting in a vegetative state despite hyperbaric oxygen therapy (HBOT), and synthesizes existing evidence to elucidate pathogenesis and propose prevention protocols. CAE demands protocol-driven vigilance in PKP and analogous spinal procedures. Preoperative risk stratification, standardized intraoperative safeguards, and immediate HBOT initiation are critical to mitigate this complication. Our proposed multiphase protocol provides actionable guidelines for prevention and acute management.

脑空气栓塞（CAE）是经皮椎体后凸成形术（PKP）一种罕见但后果严重的并发症，脊柱外科文献中仅有6例相关报道。本研究报告了1例PKP术后发生CAE的新病例，尽管进行了高压氧治疗（HBOT），患者仍处于植物状态，并综合现有证据阐明其发病机制，提出预防方案。在PKP及类似脊柱手术中，应对CAE保持基于方案的警惕。术前风险分层、标准化的术中防护措施以及立即启动高压氧治疗对于减少这一并发症至关重要。我们提出的多阶段方案为预防和急性处理提供了切实可行的指导原则。

REF: Fang T, Xue Z, Yang L, et al. Cerebral Air Embolism After Percutaneous Kyphoplasty: A Case Report and Systematic Review of Mechanisms and Management. World Neurosurg. 2025;199:124074. doi:10.1016/j.wneu.2025.124074 PMID: 40368090

Advance on Blast-Induced Traumatic Brain Injury

爆炸伤致创伤性脑损伤的研究进展

Blast-induced traumatic brain injury (bTBI) is an injury to brain tissue caused by the blast shock wave of an explosive, which is the leading cause of death and disability among military personnel during wartime. By establishing animal models of bTBI that simulate different degrees and types of injuries, it is possible to clarify the neuropathological changes including molecular and cellular mechanisms. The aim of this review is to summarize the establishment of animal models of bTBI, the mechanism, diagnosis, treatment and brain-related diseases of bTBI, which will provide a basis for improving the understanding of bTBI.

爆炸所致创伤性脑损伤（bTBI）是由爆炸物的冲击波对脑组织造成的损伤，是战时军事人员死亡和致残的主要原因。通过建立模拟不同程度和类型损伤的bTBI动物模型，有可能阐明包括分子和细胞机制在内的神经病理变化。本文旨在总结bTBI动物模型的建立、bTBI的机制、诊断、治疗及相关脑部疾病，为加深对bTBI的认识提供依据。

REF: Wang Z, Cheng F, Shi X, Dai J, Jin H, Liu Y. Advance on Blast-Induced Traumatic Brain Injury. World Neurosurg. 2025;199:124115. doi:10.1016/j.wneu.2025.124115 PMID: 40414539

Precision versus Tradition: A Meta-Analysis Comparing Robotic and Conventional Minimally Invasive Pedicle Screw Instrumentation in Thoracolumbar Fractures

精准与传统：比较机器人与传统微创椎弓根螺钉置入治疗胸腰椎骨折的荟萃分析

Robotic-assisted minimally invasive surgery (RA-MIS) is becoming increasingly applied to spinal surgery, offering an alternative to conventional minimally invasive spinal surgery (C-MIS). Recently, RA-MIS has been proposed for pedicle screw instrumentation in thoracolumbar fractures. This review aims to evaluate RA-MIS and C-MIS among the thoracolumbar fracture population. Robotic-assisted minimally invasive spinal surgery is superior in terms of higher pedicle screw accuracy and reduced perioperative blood loss, at the cost of significantly higher costs of surgery. Furthermore, we observed no clear advantages regarding complication rate and total operation time. Future trials should provide a less biased methodology to confirm the findings.

机器人辅助微创手术（RA - MIS）在脊柱手术中的应用日益广泛，为传统脊柱微创手术（C - MIS）提供了一种替代方案。最近，RA - MIS已被用于胸腰椎骨折的椎弓根螺钉置入。本综述旨在评估RA - MIS和C - MIS在胸腰椎骨折患者中的应用情况。机器人辅助脊柱微创手术在提高椎弓根螺钉置入准确性和减少围手术期失血量方面更具优势，但手术成本显著更高。此外，在并发症发生率和总手术时间方面，我们未观察到明显优势。未来的试验应采用更无偏倚的方法来证实这些结果。

REF: Łajczak P, Sahin OK, Sharma E, Ayesha A, Łajczak A. Precision versus Tradition: A Meta-Analysis Comparing Robotic and Conventional Minimally Invasive Pedicle Screw Instrumentation in Thoracolumbar Fractures. World Neurosurg. 2025;199:124109. doi:10.1016/j.wneu.2025.124109 PMID: 40414538

Surgical Nerve Decompression at Lower Extremity for Diabetic Neuropathy: A Systematic Review and Meta-Analysis of Time-Dependent Pain, Sensory Recovery, Amputation, Ulcer Recurrence, and Balance

下肢手术神经减压治疗糖尿病神经病变：一项关于时间依赖性疼痛、感觉恢复、截肢、溃疡复发和平衡的系统评价与Meta分析

This systematic review and meta-analysis evaluated the efficacy of surgical nerve decompression in patients with diabetic peripheral neuropathy, focusing on pain relief over time, comprehensive sensory function, reduction in ulcer recurrence, amputation prevention, and balance improvement. Surgical nerve decompression demonstrates sustained efficacy in pain management and substantially reduces severe diabetic neuropathy complications. Future high-quality randomized controlled trials are necessary to standardize outcomes and confirm long-term benefits.

这项系统评价和荟萃分析评估了手术神经减压术对糖尿病周围神经病变患者的疗效，重点关注随时间推移的疼痛缓解情况、综合感觉功能、溃疡复发减少情况、截肢预防情况以及平衡能力改善情况。手术神经减压术在疼痛管理方面显示出持续疗效，并显著降低了严重糖尿病神经病变并发症的发生。未来有必要开展高质量的随机对照试验，以规范治疗结果并证实其长期益处。

REF: Naghizadeh S, Zohrabi-Fard M, Keramati AA, et al. Surgical Nerve Decompression at Lower Extremity for Diabetic Neuropathy: A Systematic Review and Meta-Analysis of Time-Dependent Pain, Sensory Recovery, Amputation, Ulcer Recurrence, and Balance. World Neurosurg. 2025;199:124114. doi:10.1016/j.wneu.2025.124114 PMID: 40412529

Timing of Intracranial Pressure Monitoring in Traumatic Brain Injury: A Systematic Review and Meta-Analysis

创伤性脑损伤颅内压监测的时机：系统评价与Meta分析

This study reviews the effect of the timing of intracranial pressure (ICP) monitor placement on mortality and length of hospital and intensive care unit stay outcomes. The systematic review and meta-analysis revealed no significant differences in mortality, hospital length of stay, and intensive care unit length of stay between early and late ICP monitoring in TBI patients. The lack of definitive evidence underscores the need for further research to establish optimal timing and improve clinical outcomes in TBI management.

本研究回顾了颅内压（ICP）监测仪置入时机对死亡率、住院时长和重症监护病房住院时长等结局的影响。该系统评价和荟萃分析显示，在创伤性脑损伤（TBI）患者中，早期和晚期进行颅内压监测在死亡率、住院时长和重症监护病房住院时长方面均无显著差异。由于缺乏确凿证据，因此有必要开展进一步研究，以确定最佳的监测时机并改善创伤性脑损伤管理的临床结局。

REF: Abdollahifard S, Moshfeghinia R, Najibi A, Moradi M, Motiei-Langroudi R. Timing of Intracranial Pressure Monitoring in Traumatic Brain Injury: A Systematic Review and Meta-Analysis. World Neurosurg. 2025;199:124136. doi:10.1016/j.wneu.2025.124136 PMID: 40449835

Cell-Intrinsic and Cell-Extrinsic Therapeutic Targets in Glioblastoma: Overcoming Resistance Through Tumor Microenvironment Modulation and Precision Medicine

胶质母细胞瘤的细胞内在和细胞外在治疗靶点：通过肿瘤微环境调节和精准医学克服耐药性

Glioblastoma (GBM) is an aggressive primary brain tumor with poor prognosis despite multimodal treatment. While prior research focused on tumor cell evolution, growing evidence highlights the tumor microenvironment (TME) as a key driver of therapeutic resistance and disease progression. Understanding GBM-TME interactions is crucial for identifying novel therapeutic targets. Recurrent GBM shifts toward a mesenchymal phenotype, driving resistance. Targeting mesenchymal transition pathways, such as activator protein 1 modulation, may improve therapy. Additionally, reversing CD8+ T-cell exhaustion and regulatory T cell-mediated immunosuppression could enhance immunotherapy. Disrupting TME-mediated signaling represents a promising strategy to overcome resistance. This review highlights both cell-intrinsic and cell-extrinsic therapeutic targets and insights from single-cell multiomics for future GBM treatments.

胶质母细胞瘤（GBM）是一种侵袭性原发性脑肿瘤，尽管采用了多模式治疗，预后仍较差。此前的研究主要聚焦于肿瘤细胞的进化，而越来越多的证据表明，肿瘤微环境（TME）是导致治疗抵抗和疾病进展的关键因素。了解GBM与TME的相互作用对于确定新的治疗靶点至关重要。复发性GBM会向间充质表型转变，从而导致耐药。靶向间充质转化途径，如调节激活蛋白1，可能会改善治疗效果。此外，逆转CD8+ T细胞耗竭和调节性T细胞介导的免疫抑制可增强免疫治疗效果。破坏TME介导的信号传导是克服耐药性的一种有前景的策略。本综述重点介绍了细胞内和细胞外的治疗靶点，以及单细胞多组学技术为未来GBM治疗提供的见解。

REF: Shah S, Lucke-Wold B. Cell-Intrinsic and Cell-Extrinsic Therapeutic Targets in Glioblastoma: Overcoming Resistance Through Tumor Microenvironment Modulation and Precision Medicine. World Neurosurg. 2025;199:124142. doi:10.1016/j.wneu.2025.124142 PMID: 40480545